马来酸左旋氨氯地平与酒石酸美托洛尔联合治疗稳定型心绞痛的临床观察

Clinical observation on levoamlodipine maleate with metoprolol tartrate to treat stable angina pectoris

目的探讨马来酸左旋氨氯地平联用酒石酸美托洛尔治疗稳定型心绞痛的临床疗效。方法 42例稳定型心绞痛患者随机分为两组。A组21例,在常规硝酸酯类药物和阿司匹林药物治疗的基础上加服马来酸左旋氨氯地平初始量2.5 mg/次,1次/d,依患者耐受性渐增至5 mg/次;酒石酸美托洛尔初始量6.25 mg/次,2次/d,依患者耐受性渐增至12.5 mg/次。B组21例,在常规硝酸酯类药物和阿司匹林药物治疗的基础上加服马来酸左旋氨氯地平初始量2.5 mg/次,1次/d,依患者耐受性渐增至5 mg/次;12周后观察心绞痛缓解情况及心电图变化。结果两组均能减少心绞痛发作次数和发作时间,心电图得到改善,A组总有效率90.5%,B组总有效率71.4%,两组比较在心绞痛治疗效果上差异有统计学意义(P<0.05)。A组出现头胀1例,肢端冰冷1例,面色潮红1例,不良反应发生率14.3%;B组出现面红2例,心悸3例,头胀1例,不良反应发生率28.6%,两组比较在不良反应上差异有统计学意义。结论马来酸左旋氨氯地平联用酒石酸美托洛尔治疗稳定型心绞痛可增加疗效,并减少不良反应。

Objective To investigate the clinical curative effects of levoamlodipine maleate with metoprolol tartrate in treatment of stable angina pectoris. Methods 42 patients with stable angina pectoris were randomly divided into two groups.21 cases in group A,based on routine nitrates and aspirin therapy,were given levoamlodipine maleate with an initial amount of 2.5 mg once for 1 time per day,then increased to 5 mg once according to the tolerance of patients;metoprolol tartrate with an initial amount of 6.25 mg once for 2 times per day,then increased to 12.5 mg once according to the tolerance of patients.21 cases in group B,based on routine nitrates and aspirin therapy,were given levoamlodipine maleate with an initial amount of 2.5 mg once for 1 time per day,then increased to 5 mg once according to the tolerance of patients.After 12 weeks,angina relief status and ECG changes were observed. Results Both groups could reduce the frequency of angina pectoris attack frequency and time with ECG improvement.The total efficiency of group A was 90.5% while 71.4% of group B,and the comparison between the two groups in the therapeutic effects on angina pectoris showed significant difference（ P 〈0.05）.In group A there was 1 case of headache,1 case of cold extremities and 1 case of facial flushing,and the adverse reaction rate was 14.3%.In group B,there were 2 cases of facial flushing,3 cases of palpitation and 1 case of headache,and the adverse reaction rate was 28.6%.Comparison between the two groups showed adverse reaction with significant difference. Conclusion Levoamlodipine maleate combined with metoprolol tartrate in treatment of stable angina pectoris can increase the curative effects and decrease adverse reactions.